title: Ifosfamide neurotoxicty in a young female with a remarkable response to thiamine.
abstract: Ifosfamide, a commonly used chemotherapeutic agent in various regimens for many malignancies and has a well known central nervous system side effect. Ifosfamide induced encephalopathy develops in approximately 10-30% of patients exposed to the drug. It is generally reversible after discontinuing the therapy; however cases of fatal neurotoxicity have been reported in literature. Commonly used antidote, Methylene blue; has a moderate efficacy in reversing the encephalopathy followed by lesser response rates by Thiamine. We submit a case report of a young female patient with refractory diffuse large B cell lymphoma who developed severe ifosfamide neurotoxicity. With the use of intravenous thiamine, encephalopathy resolved in our patient within a mean time of 30 hours (average range is 10-30 hours). We found Thiamine to be safe and effective in treatment for ifosfamide induced encephalopathy.
authors.affiliation: Department of Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore.
authors.forename: Saba
authors.initials: S
authors.lastname: Imtiaz
authors.forename: Narjis
authors.initials: N
authors.lastname: Muzaffar
mesh_terms: D000328:Adult; D018906:Antineoplastic Agents, Alkylating / Q000009:adverse effects*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002490:Central Nervous System / Q000187:drug effects; D005260:Female; D006801:Humans; D007069:Ifosfamide / Q000009:adverse effects*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy* / Q000473:pathology; D020258:Neurotoxicity Syndromes / Q000188:drug therapy* / Q000209:etiology; D013831:Thiamine / Q000627:therapeutic use*; D016896:Treatment Outcome; D014803:Vitamin B Complex / Q000627:therapeutic use*
chemical_list: D018906:Antineoplastic Agents, Alkylating; D014803:Vitamin B Complex; D007069:Ifosfamide; D013831:Thiamine